Combination ultrasonic and electrosurgical system having generator filter circuitry

ABSTRACT

A surgical system includes a surgical instrument having a body, a shaft extending distally from the body, an ultrasonic transducer supported by the body, and an end effector at a distal end of the shaft. The end effector includes an ultrasonic blade configured to be driven by the ultrasonic transducer with ultrasonic energy, and an RF electrode operable to seal tissue with RF energy. A generator is operatively coupled with the surgical instrument and is operable to generate a combined drive signal having an ultrasonic energy component and an RF energy component. Filter circuitry arranged externally of the body of the surgical instrument is operable to convert the combined drive signal to an ultrasonic drive signal configured to energize the ultrasonic transducer to drive the ultrasonic blade with ultrasonic energy, and an RF drive signal configured to energize the RF electrode with RF energy sufficient to seal tissue.

This application claims the benefit of U.S. Provisional App. No.62/509,351, entitled “Ultrasonic Instrument With ElectrosurgicalFeatures,” filed May 22, 2017, the disclosure of which is incorporatedby reference herein.

BACKGROUND

Ultrasonic surgical instruments utilize ultrasonic energy for bothprecise cutting and controlled coagulation of tissue. The ultrasonicenergy cuts and coagulates by vibrating a blade in contact with thetissue. Vibrating at frequencies of approximately 50 kilohertz (kHz),for example, the ultrasonic blade denatures protein in the tissue toform a sticky coagulum. Pressure exerted on the tissue with the bladesurface collapses blood vessels and allows the coagulum to form ahemostatic seal. The precision of cutting and coagulation may becontrolled by the surgeon's technique and adjusting the power level,blade edge, tissue traction, and blade pressure, for example.

Examples of ultrasonic surgical devices include the HARMONIC ACE®Ultrasonic Shears, the HARMONIC WAVE® Ultrasonic Shears, the HARMONICFOCUS® Ultrasonic Shears, and the HARMONIC SYNERGY® Ultrasonic Blades,all by Ethicon Endo-Surgery, Inc. of Cincinnati, Ohio. Further examplesof such devices and related concepts are disclosed in U.S. Pat. No.5,322,055, entitled “Clamp Coagulator/Cutting System for UltrasonicSurgical Instruments,” issued Jun. 21, 1994, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 5,873,873, entitled“Ultrasonic Clamp Coagulator Apparatus Having Improved Clamp Mechanism,”issued Feb. 23, 1999, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 5,980,510, entitled “Ultrasonic ClampCoagulator Apparatus Having Improved Clamp Arm Pivot Mount,” issued Nov.9, 1999, the disclosure of which is incorporated by reference herein;U.S. Pat. No. 6,283,981, entitled “Method of Balancing AsymmetricUltrasonic Surgical Blades,” issued Sep. 4, 2001, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 6,309,400,entitled “Curved Ultrasonic Blade having a Trapezoidal Cross Section,”issued Oct. 30, 2001, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 6,325,811, entitled “Blades withFunctional Balance Asymmetries for use with Ultrasonic SurgicalInstruments,” issued Dec. 4, 2001, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 6,423,082, entitled“Ultrasonic Surgical Blade with Improved Cutting and CoagulationFeatures,” issued Jul. 23, 2002, the disclosure of which is incorporatedby reference herein; U.S. Pat. No. 6,773,444, entitled “Blades withFunctional Balance Asymmetries for Use with Ultrasonic SurgicalInstruments,” issued Aug. 10, 2004, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 6,783,524, entitled“Robotic Surgical Tool with Ultrasound Cauterizing and CuttingInstrument,” issued Aug. 31, 2004, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 8,057,498, entitled“Ultrasonic Surgical Instrument Blades,” issued Nov. 15, 2011, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.8,461,744, entitled “Rotating Transducer Mount for Ultrasonic SurgicalInstruments,” issued Jun. 11, 2013, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 8,591,536, entitled“Ultrasonic Surgical Instrument Blades,” issued Nov. 26, 2013, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.8,623,027, entitled “Ergonomic Surgical Instruments,” issued Jan. 7,2014, the disclosure of which is incorporated by reference herein; U.S.Pat. No. 9,095,367, entitled “Flexible Harmonic Waveguides/Blades forSurgical Instruments,” issued Aug. 4, 2015, the disclosure of which isincorporated by reference herein; and U.S. Pub. No. 2016/0022305,entitled “Ultrasonic Blade Overmold,” published Jan. 28, 2016, thedisclosure of which is incorporated by reference herein.

Electrosurgical instruments utilize electrical energy for sealingtissue, and generally include a distally mounted end effector that canbe configured for bipolar or monopolar operation. During bipolaroperation, electrical current is provided through the tissue by activeand return electrodes of the end effector. During monopolar operation,current is provided through the tissue by an active electrode of the endeffector and a return electrode (e.g., a grounding pad) separatelylocated on a patient's body. Heat generated by the current flowingthrough the tissue may form hemostatic seals within the tissue and/orbetween tissues, and thus may be particularly useful for sealing bloodvessels, for example. The end effector of an electrosurgical device mayalso include a cutting member that is movable relative to the tissue andthe electrodes to transect the tissue.

Electrical energy applied by an electrosurgical device can betransmitted to the instrument by a generator coupled with theinstrument. The electrical energy may be in the form of radio frequency(“RF”) energy, which is a form of electrical energy generally in thefrequency range of approximately 300 kilohertz (kHz) to 1 megahertz(MHz). In use, an electrosurgical device can transmit lower frequency RFenergy through tissue, which causes ionic agitation, or friction, ineffect resistive heating, thereby increasing the temperature of thetissue. Because a sharp boundary is created between the affected tissueand the surrounding tissue, surgeons can operate with a high level ofprecision and control, without sacrificing un-targeted adjacent tissue.The low operating temperatures of RF energy may be useful for removing,shrinking, or sculpting soft tissue while simultaneously sealing bloodvessels. RF energy works particularly well on connective tissue, whichis primarily comprised of collagen and shrinks when contacted by heat.

An example of an RF electrosurgical device is the ENSEAL® Tissue SealingDevice by Ethicon Endo-Surgery, Inc., of Cincinnati, Ohio. Furtherexamples of electrosurgical devices and related concepts are disclosedin U.S. Pat. No. 6,500,176 entitled “Electrosurgical Systems andTechniques for Sealing Tissue,” issued Dec. 31, 2002, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 7,112,201entitled “Electrosurgical Instrument and Method of Use,” issued Sep. 26,2006, the disclosure of which is incorporated by reference herein; U.S.Pat. No. 7,125,409, entitled “Electrosurgical Working End for ControlledEnergy Delivery,” issued Oct. 24, 2006, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 7,169,146 entitled“Electrosurgical Probe and Method of Use,” issued Jan. 30, 2007, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.7,186,253, entitled “Electrosurgical Jaw Structure for Controlled EnergyDelivery,” issued Mar. 6, 2007, the disclosure of which is incorporatedby reference herein; U.S. Pat. No. 7,189,233, entitled “ElectrosurgicalInstrument,” issued Mar. 13, 2007, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 7,220,951, entitled“Surgical Sealing Surfaces and Methods of Use,” issued May 22, 2007, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.7,309,849, entitled “Polymer Compositions Exhibiting a PTC Property andMethods of Fabrication,” issued Dec. 18, 2007, the disclosure of whichis incorporated by reference herein; U.S. Pat. No. 7,311,709, entitled“Electrosurgical Instrument and Method of Use,” issued Dec. 25, 2007,the disclosure of which is incorporated by reference herein; U.S. Pat.No. 7,354,440, entitled “Electrosurgical Instrument and Method of Use,”issued Apr. 8, 2008, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 7,381,209, entitled “ElectrosurgicalInstrument,” issued Jun. 3, 2008, the disclosure of which isincorporated by reference herein.

Additional examples of electrosurgical devices and related concepts aredisclosed in U.S. Pat. No. 8,939,974, entitled “Surgical InstrumentComprising First and Second Drive Systems Actuatable by a Common TriggerMechanism,” issued Jan. 27, 2015, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 9,161,803, entitled“Motor Driven Electrosurgical Device with Mechanical and ElectricalFeedback,” issued Oct. 20, 2015, the disclosure of which is incorporatedby reference herein; U.S. Pub. No. 2012/0078243, entitled “ControlFeatures for Articulating Surgical Device,” published Mar. 29, 2012, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.9,402,682, entitled “Articulation Joint Features for ArticulatingSurgical Device,” issued Aug. 2, 2016, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 9,089,327, entitled“Surgical Instrument with Multi-Phase Trigger Bias,” issued Jul. 28,2015, the disclosure of which is incorporated by reference herein; U.S.Pat. No. 9,545,253, entitled “Surgical Instrument with Contained DualHelix Actuator Assembly,” issued Jan. 17, 2017, the disclosure of whichis incorporated by reference herein; and U.S. Pat. No. 9,572,622,entitled “Bipolar Electrosurgical Features for Targeted Hemostasis,”issued Feb. 21, 2017, the disclosure of which is incorporated byreference herein.

Some instruments may provide ultrasonic and RF energy treatmentcapabilities through a single surgical device. Examples of such devicesand related methods and concepts are disclosed in U.S. Pat. No.8,663,220, entitled “Ultrasonic Surgical Instruments,” issued Mar. 4,2014, the disclosure of which is incorporated by reference herein; U.S.Pub. No. 2015/0141981, entitled “Ultrasonic Surgical Instrument withElectrosurgical Feature,” published May 21, 2015, the disclosure ofwhich is incorporated by reference herein; and U.S. Pub. No.2017/0000541, entitled “Surgical Instrument with User AdaptableTechniques,” published Jan. 5, 2017, the disclosure of which isincorporated by reference herein.

While various types of ultrasonic surgical instruments andelectrosurgical instruments, including combinationultrasonic-electrosurgical instruments, have been made and used, it isbelieved that no one prior to the inventor(s) has made or used theinvention described in the appended claims.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate embodiments of the invention,and, together with the general description of the invention given above,and the detailed description of the embodiments given below, serve toexplain the principles of the present invention.

FIG. 1 depicts a perspective view of an exemplary surgical system havinga generator and a surgical instrument operable to treat tissue withultrasonic energy and bipolar RF energy;

FIG. 2 depicts a top perspective view of an end effector of the surgicalinstrument of FIG. 1, having a clamp arm that provides a first electrodeand an ultrasonic blade that provides a second electrode;

FIG. 3 depicts a bottom perspective view of the end effector of FIG. 2;

FIG. 4 depicts a partially exploded perspective view of the surgicalinstrument of FIG. 1;

FIG. 5 depicts an enlarged exploded perspective view of a distal portionof the shaft assembly and the end effector of the surgical instrument ofFIG. 1;

FIG. 6 depicts a side elevational view of a distal portion of an innertube of the shaft assembly of the surgical instrument of FIG. 1;

FIG. 7 depicts a partially schematic view of an exemplary surgicalsystem incorporating the surgical instrument of FIG. 1 having aninternally mounted ultrasonic transducer, an exemplary power cable, anadapter, and a generator;

FIG. 8 depicts a partially schematic view of another exemplary surgicalsystem incorporating a surgical instrument having an externally mountedultrasonic transducer, a power cable, an adapter, and a generator;

FIG. 9 depicts a schematic view of an exemplary surgical systemincluding a surgical instrument, filter circuitry, and a generator;

FIG. 10 depicts a schematic view of an exemplary version of the surgicalsystem of FIG. 9, in which the filter circuitry is arranged within anaccessory of the surgical system;

FIG. 11 depicts a schematic view of another exemplary version of thesurgical system of FIG. 9, in which the filter circuitry is arrangedwithin the generator of the surgical system;

FIG. 12 depicts a schematic view of another exemplary version of thesurgical system of FIG. 9, in which the filter circuitry is arrangedwithin the surgical instrument of the surgical system;

FIG. 13 depicts a side elevational view of the surgical instrument ofFIG. 7 with a side body portion of the handle assembly omitted, thesurgical instrument including filter circuitry according to theexemplary system configuration of FIG. 12, the filter circuitryschematically shown arranged at several optional locations within thehandle assembly; and

FIG. 14 depicts a side elevational view of the surgical instrument ofFIG. 8, the surgical instrument including filter circuitry according tothe exemplary system configuration of FIG. 12, the filter circuitryschematically shown arranged within the externally mounted ultrasonictransducer.

The drawings are not intended to be limiting in any way, and it iscontemplated that various embodiments of the invention may be carriedout in a variety of other ways, including those not necessarily depictedin the drawings. The accompanying drawings incorporated in and forming apart of the specification illustrate several aspects of the presentinvention, and together with the description serve to explain theprinciples of the invention; it being understood, however, that thisinvention is not limited to the precise arrangements shown.

DETAILED DESCRIPTION

The following description of certain examples of the invention shouldnot be used to limit the scope of the present invention. Other examples,features, aspects, embodiments, and advantages of the invention willbecome apparent to those skilled in the art from the followingdescription, which is by way of illustration, one of the best modescontemplated for carrying out the invention. As will be realized, theinvention is capable of other different and obvious aspects, all withoutdeparting from the invention. Accordingly, the drawings and descriptionsshould be regarded as illustrative in nature and not restrictive.

For clarity of disclosure, the terms “proximal” and “distal” are definedherein relative to a surgeon, or other operator, grasping a surgicalinstrument having a distal surgical end effector. The term “proximal”refers to the position of an element arranged closer to the surgeon, andthe term “distal” refers to the position of an element arranged closerto the surgical end effector of the surgical instrument and further awayfrom the surgeon. Moreover, to the extent that spatial terms such as“upper,” “lower,” “vertical,” “horizontal,” or the like are used hereinwith reference to the drawings, it will be appreciated that such termsare used for exemplary description purposes only and are not intended tobe limiting or absolute. In that regard, it will be understood thatsurgical instruments such as those disclosed herein may be used in avariety of orientations and positions not limited to those shown anddescribed herein.

I. Exemplary Surgical System Having Surgical Instrument with Ultrasonicand Electrosurgical Features

FIG. 1 depicts an exemplary surgical system (10) including a generator(12) and a surgical instrument (14). Surgical instrument (14) isoperatively coupled with the generator (12) via power cable (16). Asdescribed in greater detail below, generator (12) is operable to powersurgical instrument (14) to deliver ultrasonic energy for cuttingtissue, and electrosurgical bipolar RF energy (i.e., therapeutic levelsof RF energy) for sealing tissue. In exemplary configurations, generator(12) is configured to power surgical instrument (14) to deliverultrasonic energy and electrosurgical bipolar RF energy simultaneously.

Surgical instrument (14) of the present example comprises a handleassembly (18), a shaft assembly (20) extending distally from the handleassembly (18), and an end effector (22) arranged at a distal end of theshaft assembly (20). Handle assembly (18) comprises a body (24)including a pistol grip (26) and energy control buttons (28, 30)configured to be manipulated by a surgeon. A trigger (32) is coupled toa lower portion of body (24) and is pivotable toward and away frompistol grip (26) to selectively actuate end effector (22), as describedin greater detail below. In other suitable variations of surgicalinstrument (14), handle assembly (18) may comprise a scissor gripconfiguration, for example. As described in greater detail below, anultrasonic transducer (34) is housed internally within and supported bybody (24). In other configurations, ultrasonic transducer (34) may beprovided externally of body (24) for example as shown in the exemplaryconfiguration of FIG. 14.

As shown in FIGS. 2 and 3, end effector (22) includes an ultrasonicblade (36) and a clamp arm (38) configured to selectively pivot towardand away from ultrasonic blade (36), for clamping tissue therebetween.Ultrasonic blade (36) is acoustically coupled with ultrasonic transducer(34), which is configured to drive (i.e., vibrate) ultrasonic blade (36)at ultrasonic frequencies for cutting and/or sealing tissue positionedin contact with ultrasonic blade (36). Clamp arm (38) is operativelycoupled with trigger (32) such that clamp arm (38) is configured topivot toward ultrasonic blade (36), to a closed position, in response topivoting of trigger (32) toward pistol grip (26). Further, clamp arm(38) is configured to pivot away from ultrasonic blade (36), to an openposition (see e.g., FIGS. 1-3), in response to pivoting of trigger (32)away from pistol grip (26). Various suitable ways in which clamp arm(38) may be coupled with trigger (32) will be apparent to those ofordinary skill in the art in view of the teachings provided herein. Insome versions, one or more resilient members may be incorporated to biasclamp arm (38) and/or trigger (32) toward the open position.

A clamp pad (40) is secured to and extends distally along a clampingside of clamp arm (38), facing ultrasonic blade (36). Clamp pad (40) isconfigured to engage and clamp tissue against a corresponding tissuetreatment portion of ultrasonic blade (36) when clamp arm (38) isactuated to its closed position. At least a clamping-side of clamp arm(38) provides a first electrode (42), referred to herein as clamp armelectrode (42). Additionally, at least a clamping-side of ultrasonicblade (36) provides a second electrode (44), referred to herein as ablade electrode (44). As described in greater detail below, electrodes(42, 44) are configured to apply electrosurgical bipolar RF energy,provided by generator (12), to tissue electrically coupled withelectrodes (42, 44). Clamp arm electrode (42) may serve as an activeelectrode while blade electrode (44) serves as a return electrode, orvice-versa. Surgical instrument (14) may be configured to apply theelectrosurgical bipolar RF energy through electrodes (42, 44) whilevibrating ultrasonic blade (36) at an ultrasonic frequency, beforevibrating ultrasonic blade (36) at an ultrasonic frequency, and/or aftervibrating ultrasonic blade (36) at an ultrasonic frequency.

As shown in FIGS. 1-5, shaft assembly (20) extends along a longitudinalaxis and includes an outer tube (46), an inner tube (48) received withinouter tube (46), and an ultrasonic waveguide (50) supported within innertube (48). As seen best in FIGS. 2-5, clamp arm (38) is coupled todistal ends of inner and outer tubes (46, 48). In particular, clamp arm(38) includes a pair of proximally extending clevis arms (52) thatreceive therebetween and pivotably couple to a distal end (54) of innertube (48) with a pivot pin (56) received within through bores formed inclevis arms (52) and distal end (54) of inner tube (48). First andsecond clevis fingers (58) depend downwardly from clevis arms (52) andpivotably couple to a distal end (60) of outer tube (46). Specifically,each clevis finger (58) includes a protrusion (62) that is rotatablyreceived within a corresponding opening (64) formed in a sidewall ofdistal end (60) of outer tube (46).

In the present example, inner tube (48) is longitudinally fixed relativeto handle assembly (18), and outer tube (46) is configured to translaterelative to inner tube (48) and handle assembly (18), along thelongitudinal axis of shaft assembly (20). As outer tube (46) translatesdistally, clamp arm (38) pivots about pivot pin (56) toward its openposition. As outer tube (46) translates proximally, clamp arm (38)pivots in an opposite direction toward its closed position. A proximalend of outer tube (46) is operatively coupled with trigger (32), forexample via a linkage assembly, such that actuation of trigger (32)causes translation of outer tube (46) relative to inner tube (48),thereby opening or closing clamp arm (38). In other suitableconfigurations not shown herein, outer tube (46) may be longitudinallyfixed and inner tube (48) may be configured to translate for movingclamp arm (38) between its open and closed positions.

Shaft assembly (20) and end effector (22) are configured to rotatetogether about the longitudinal axis, relative to handle assembly (18).A retaining pin (66), shown in FIG. 4, extends transversely throughproximal portions of outer tube (46), inner tube (48), and waveguide(50) to thereby couple these components rotationally relative to oneanother. In the present example, a rotation knob (68) is provided at aproximal end portion of shaft assembly (20) to facilitate rotation ofshaft assembly (20), and end effector (22), relative to handle assembly(18). Rotation knob (68) is secured rotationally to shaft assembly (20)with retaining pin (66), which extends through a proximal collar ofrotation knob (68). It will be appreciated that in other suitableconfigurations, rotation knob (68) may be omitted or substituted withalternative rotational actuation structures.

Ultrasonic waveguide (50) is acoustically coupled at its proximal endwith ultrasonic transducer (34), for example by a threaded connection,and at its distal end with ultrasonic blade (36), as shown in FIG. 5.Ultrasonic blade (36) is shown formed integrally with waveguide (50)such that blade (36) extends distally, directly from the distal end ofwaveguide (50). In this manner, waveguide (50) acoustically couplesultrasonic transducer (34) with ultrasonic blade (36), and functions tocommunicate ultrasonic mechanical vibrations from transducer (34) toblade (36). Accordingly, ultrasonic transducer (34), waveguide (50), andultrasonic blade (36) together define acoustic assembly (100). Duringuse, ultrasonic blade (36) may be positioned in direct contact withtissue, with or without assistive clamping force provided by clamp arm(38), to impart ultrasonic vibrational energy to the tissue and therebycut and/or seal the tissue. For example, blade (36) may cut throughtissue clamped between clamp arm (38) and a first treatment side ofblade (36), or blade (36) may cut through tissue positioned in contactwith an oppositely disposed second treatment side of blade (36), forexample during a “back-cutting” movement. In some variations, waveguide(50) may amplify the ultrasonic vibrations delivered to blade (36).Further, waveguide (50) may include various features operable to controlthe gain of the vibrations, and/or features suitable to tune waveguide(50) to a selected resonant frequency. Additional exemplary features ofultrasonic blade (36) and waveguide (50) are described in greater detailbelow.

Waveguide (50) is supported within inner tube (48) by a plurality ofnodal support elements (70) positioned along a length of waveguide (50),as shown in FIGS. 4 and 5. Specifically, nodal support elements (70) arepositioned longitudinally along waveguide (50) at locationscorresponding to acoustic nodes defined by the resonant ultrasonicvibrations communicated through waveguide (50). Nodal support elements(70) may provide structural support to waveguide (50), and acousticisolation between waveguide (50) and inner and outer tubes (46, 48) ofshaft assembly (20). In exemplary variations, nodal support elements(70) may comprise o-rings. Waveguide (50) is supported at itsdistal-most acoustic node by a nodal support element in the form of anovermold member (72), shown in FIG. 5. Waveguide (50) is securedlongitudinally and rotationally within shaft assembly (20) by retainingpin (66), which passes through a transverse through-bore (74) formed ata proximally arranged acoustic node of waveguide (50), such as theproximal-most acoustic node, for example.

In the present example, a distal tip (76) of ultrasonic blade (36) islocated at a position corresponding to an anti-node associated with theresonant ultrasonic vibrations communicated through waveguide (50). Sucha configuration enables the acoustic assembly (100) of instrument (14)to be tuned to a preferred resonant frequency f_(o) when ultrasonicblade (36) is not loaded by tissue. When ultrasonic transducer (34) isenergized by generator (12) to transmit mechanical vibrations throughwaveguide (50) to blade (36), distal tip (76) of blade (36) is caused tooscillate longitudinally in the range of approximately 20 to 120 micronspeak-to-peak, for example, and in some instances in the range ofapproximately 20 to 50 microns, at a predetermined vibratory frequencyf_(o) of approximately 50 kHz, for example. When ultrasonic blade (36)is positioned in contact with tissue, the ultrasonic oscillation ofblade (36) may simultaneously sever the tissue and denature the proteinsin adjacent tissue cells, thereby providing a coagulative effect withminimal thermal spread.

As shown in FIG. 6, distal end (54) of inner tube (48) may be offsetradially outwardly relative to a remaining proximal portion of innertube (48). This configuration enables pivot pin bore (78), whichreceives clamp arm pivot pin (56), to be spaced further away from thelongitudinal axis of shaft assembly (20) than if distal end (54) whereformed flush with the remaining proximal portion of inner tube (48).Advantageously, this provides increased clearance between proximalportions of clamp arm electrode (42) and blade electrode (44), therebymitigating risk of undesired “shorting” between electrodes (42, 44) andtheir corresponding active and return electrical paths, for exampleduring back-cutting when ultrasonic blade (36) flexes toward clamp arm(38) and pivot pin (56) in response to normal force exerted on blade(36) by tissue. In other words, when ultrasonic blade (36) is used in aback-cutting operation, ultrasonic blade (36) may tend to deflectslightly away from the longitudinal axis of shaft assembly (20), towardpin (56). By having pivot pin bore (78) spaced further away from thelongitudinal axis than pivot pin bore (78) otherwise would be in theabsence of the radial offset provided by distal end (54) of the presentexample, distal end (54) provides additional lateral clearance betweenpivot pin (56) and ultrasonic blade (36), thereby reducing oreliminating the risk of contact between ultrasonic blade (36) and pivotpin (56) when ultrasonic blade (36) deflects laterally duringback-cutting operations. In addition to preventing electrical shortcircuits that would otherwise result from contact between ultrasonicblade (36) and pivot pin (56) when end effector (22) is activated toapply RF electrosurgical energy, the additional clearance preventsmechanical damage that might otherwise result from contact betweenultrasonic blade (36) and pivot pin (56) when ultrasonic blade (36) isvibrating ultrasonically.

II. Exemplary Surgical Systems with Power Cables and Cable Adapters

A. Overview of Exemplary Surgical Systems

FIG. 7 shows an exemplary surgical system (400) similar to surgicalsystem (10) in that surgical system (400) includes a generator (402), asurgical instrument (404), and a power cable (406) configured tooperatively couple surgical instrument (404) with generator (402).Surgical system (400) further includes a cable adapter (408) configuredto couple power cable (406) with an output port on generator (402),which may also function as an input port. Surgical instrument (404) maybe in the form of surgical instrument (14), and may incorporate any oneor more of the exemplary supplemental or alternative features describedabove. Surgical instrument (404) includes an internally-mountedultrasonic transducer (410), which may be in the form of ultrasonictransducer (34), described above.

Power cable (406) includes a first cable end (412) configured to couplewith surgical instrument (404), and a second cable end (414) configuredto couple with generator (402) via cable adapter (408). In the presentexample, first cable end (412) is configured to releasably couple tosurgical instrument (404), and second cable end (414) is configured toreleasably couple to a first adapter end (416) of cable adapter (408). Asecond adapter end (418) of cable adapter (408) is configured toreleasably couple to a port on generator (402). The releasable couplingsdescribed above may be achieved using any suitable coupling elementsknown in the art. By way of example only, such coupling elements mayinclude threaded elements, dynamic snap-fit elements, static snap-fitelements, magnetic elements, and/or friction fit elements. Inalternative configurations, any one or more of the releasable couplingsdescribed above may be non-releasable. For example, first cable end(412) may be non-releasably attached to surgical instrument (404),and/or second cable end (414) may be non-releasably attached to firstadapter end (416). In other configurations, any suitable combination ofreleasable and non-releasable couplings between surgical instrument(404), power cable (406), cable adapter (408), and generator (402) maybe provided.

In the exemplary configuration shown in FIG. 7, first cable end (412) ofpower cable (406) couples to a proximal end of handle assembly (420) ofsurgical instrument (404), and aligns coaxially with ultrasonictransducer (410) housed therein. It will be understood, however, thatfirst cable end (412) may couple to handle assembly (420) at variousother locations, and/or in various other orientations relative totransducer (410). For example, in one alternative configuration, firstcable end (412) may couple to a proximal portion of handle assembly(420) at a location offset from the central axis of ultrasonictransducer (410). In another alternative configuration, first cable end(412) may couple to a lower end of a pistol grip (422) of handleassembly (410).

FIG. 8 shows another exemplary surgical system (500) similar to surgicalsystems (10, 400) in that surgical system (500) includes a generator(502), a surgical instrument (504), and a power cable (506) configuredto operatively couple surgical instrument (504) with generator (502).Surgical system (500) further includes a cable adapter (508) configuredto couple power cable (506) with an output port on generator (502),which may also function as an input port. Surgical instrument (504) issimilar to surgical instrument (404), except that surgical instrument(504) includes an externally-mounted ultrasonic transducer (510) thatreleasably couples to and is supported by a handle assembly (520) ofsurgical instrument (504). Power cable (506) may be substantiallysimilar to power cable (406). Furthermore, generator (502), surgicalinstrument (504), power cable (506), and cable adapter (508) may beconfigured to couple to one another in various configurations similar tothose described above in connection with surgical system (400).

B. Exemplary Filter Circuitry

FIG. 9 schematically shows another exemplary surgical system (600) thatincludes a generator (602), a surgical instrument (604), and filtercircuitry (606). Surgical system (600) may represent any of surgicalsystems (10, 400, 500) described above. In that regard, generator (602)may represent any of generators (12, 402, 502), and surgical instrument(602) may represent any of surgical instruments (14, 404, 504), forexample.

Generator (602) is configured to generate and output a single, combineddrive waveform (or “signal”) (610) that includes an ultrasonic drivecomponent and an RF drive component. Filter circuitry (606) isconfigured to receive the single drive waveform (610) and separate itsultrasonic and RF drive components. More specifically, filter circuitry(606) converts the single drive waveform (610) into an ultrasonic drivewaveform (or “signal”) (612) and a separate RF drive waveform (or“signal”) (614). Ultrasonic drive waveform (612) is configured to drivean ultrasonic transducer of surgical instrument (602) to produceultrasonic energy for cutting and/or sealing tissue; and an RF drivewaveform (614) is configured to energize bipolar RF electrodes ofsurgical instrument (602) with electrosurgical bipolar RF energy forsealing tissue.

By way of example only, filter circuitry (606) may be constructed andfunction in accordance with the teachings of U.S. Pub. No. 2017/0086910,entitled “Techniques for Circuit Topologies for Combined Generator,”published Mar. 30, 2017, the disclosure of which is incorporated byreference herein; U.S. Pub. No. 2017/0086908, entitled “CircuitTopologies for Combined Generator,” published Mar. 30, 2017, thedisclosure of which is incorporated by reference herein; U.S. Pub. No.2017/0086911, entitled “Circuits for Supplying Isolated Direct Current(DC) Voltage to Surgical Instruments,” published Mar. 30, 2017, thedisclosure of which is incorporated by reference herein; U.S. Pub. No.2017/0086909, entitled “Frequency Agile Generator for a SurgicalInstrument,” published Mar. 30, 2017, the disclosure of which isincorporated by reference herein; and/or U.S. Pub. No. 2017/0086876,entitled “Method and Apparatus for Selecting Operations of a SurgicalInstrument Based on User Intention,” published Mar. 30, 2017, thedisclosure of which is incorporated by reference herein.

Ultrasonic and RF drive waveforms (612, 614) may be delivered to theultrasonic transducer and bipolar RF electrodes of surgical instrument(604) simultaneously, such that instrument (604) may treat tissue withsimultaneous application of ultrasonic energy and electrosurgicalbipolar RF energy. The ultrasonic and RF energies may be appliedselectively, and various parameters of the applied energies may beselectively adjusted, using user input features provided on generator(602) and/or on surgical instrument (604), such as energy controlbuttons (28, 30), for example. In various examples, surgical system(600) may be configured to deliver pre-determined levels and/or patternsof ultrasonic and/or RF energies based on energy application algorithmspre-programmed into control circuitry of surgical system (600). Suchalgorithms may include any one or more of the exemplary algorithmsdisclosed in U.S. Pat. No. 8,663,220, entitled “Ultrasonic SurgicalInstruments,” issued Mar. 4, 2014, incorporated by reference above; U.S.Pub. No. 2017/0000541, entitled “Surgical Instrument with User AdaptableTechniques,” published Jan. 5, 2017, incorporated by reference above;and/or any other patents or patent applications incorporated byreference herein.

Filter circuitry (606) may be arranged at a variety of suitablelocations within surgical system (600). FIG. 10 shows a first exemplaryversion of surgical system (600) in the form of surgical system (620),in which filter circuitry (606) is integrated with an accessory device(608), which may be in the form of a power cable or a cable adapter,such as power cables (406, 506) or cable adapters (408, 508) describedabove, for example. FIG. 11 shows a second exemplary version of surgicalsystem (600) in the form of surgical system (630), in which filtercircuitry (606) is integrated with generator (602). FIG. 12 shows athird exemplary version of surgical system (600) in the form of surgicalsystem (640), in which filter circuitry (606) is integrated withsurgical instrument (604).

FIG. 13 shows surgical instrument (404) having filter circuitry (606)arranged therein at various optional locations, in accordance with thegeneral configuration of surgical system (640) of FIG. 12. As shown, andby way of example only, filter circuitry (606) may be arranged within aproximal portion of handle assembly (420), proximally ofinternally-mounted ultrasonic transducer (410). Alternatively, filtercircuitry (606) may be arranged within a lower portion of pistol grip(422) of handle assembly (420).

FIG. 14 shows surgical instrument (504) having filter circuitry (606)arranged therein, in accordance with the general configuration ofsurgical system (640) of FIG. 12. As shown, and by way of example only,filter circuitry (606) may be integrated with externally-mountedultrasonic transducer (510).

III. Exemplary Combinations

The following examples relate to various non-exhaustive ways in whichthe teachings herein may be combined or applied. It should be understoodthat the following examples are not intended to restrict the coverage ofany claims that may be presented at any time in this application or insubsequent filings of this application. No disclaimer is intended. Thefollowing examples are being provided for nothing more than merelyillustrative purposes. It is contemplated that the various teachingsherein may be arranged and applied in numerous other ways. It is alsocontemplated that some variations may omit certain features referred toin the below examples. Therefore, none of the aspects or featuresreferred to below should be deemed critical unless otherwise explicitlyindicated as such at a later date by the inventors or by a successor ininterest to the inventors. If any claims are presented in thisapplication or in subsequent filings related to this application thatinclude additional features beyond those referred to below, thoseadditional features shall not be presumed to have been added for anyreason relating to patentability.

Example 1

A surgical system comprising: (a) a surgical instrument, comprising: (i)a body, (ii) a shaft extending distally from the body, (iii) anultrasonic transducer supported by the body, and (iv) an end effectorarranged at a distal end of the shaft, wherein the end effectorcomprises: (A) an ultrasonic blade, wherein the ultrasonic transducer isoperable to drive the ultrasonic blade with ultrasonic energy, and (B)an RF electrode operable to seal tissue with RF energy; (b) a generatoroperatively coupled with the surgical instrument, wherein the generatoris operable to generate a combined drive signal having an ultrasonicenergy component and an RF energy component; and (c) filter circuitryarranged externally of the body of the surgical instrument, wherein thefilter circuitry is operable to convert the combined drive signal to:(i) an ultrasonic drive signal configured to energize the ultrasonictransducer to drive the ultrasonic blade with ultrasonic energy, and(ii) an RF drive signal configured to energize the RF electrode with RFenergy sufficient to seal tissue.

Example 2

The surgical system of Example 1, further comprising (a) a power cableconfigured to couple to the surgical instrument; and (b) a cable adapterconfigured to couple the power cable with the generator, wherein thefilter circuitry is arranged within one of the power cable or the cableadapter.

Example 3

The surgical system of Example 2, wherein the power cable is configuredto releasably couple to the cable adapter.

Example 4

The surgical system of any Examples 2 through 3, wherein the filtercircuitry is arranged within the cable adapter.

Example 5

The surgical system of any of Examples 2 through 3, wherein the filtercircuitry is arranged within the power cable.

Example 6

The surgical system of Example 1, wherein the filter circuitry isintegrated with the generator.

Example 7

The surgical system of any of the previous Examples, wherein a distalend of the power cable is configured to releasably couple with the body.

Example 8

The surgical system of any of the previous Examples, wherein a distalend of the power cable is configured to couple with a proximal end ofthe body.

Example 9

The surgical system of any of Examples 7 through 8, wherein the distalend of the cable is configured to align coaxially with the ultrasonictransducer when the power cable is coupled with the body.

Example 10

The surgical system of any of the previous Examples, wherein theultrasonic transducer is housed within an interior of the body.

Example 11

The surgical system of any of Examples 1 through 9, wherein theultrasonic transducer is supported externally of the body.

Example 12

The surgical system of any of the previous Examples, wherein the filtercircuitry is integrated with the ultrasonic transducer.

Example 13

The surgical system of any of the previous Examples, wherein the RFelectrode is provided by the ultrasonic blade.

Example 14

The surgical system of any of the previous Examples, wherein the RFelectrode comprises a first RF electrode, wherein the RF drive signal isconfigured to energize the first and second RF electrodes with bipolarRF energy sufficient to seal tissue.

Example 15

The surgical system of Example 14, wherein the end effector furthercomprises a clamp arm, wherein the clamp arm provides the first RFelectrode and the ultrasonic blade provides the second RF electrode.

Example 16

A surgical system comprising: (a) a surgical instrument, comprising: (i)an ultrasonic transducer, (ii) a shaft extending distally relative tothe ultrasonic transducer, and (iii) an end effector arranged at adistal end of the shaft, wherein the end effector comprises: (A) anultrasonic blade, wherein the ultrasonic transducer is operable to drivethe ultrasonic blade with ultrasonic energy, and (B) an RF electrodeoperable to seal tissue with RF energy; (b) a generator operativelycoupled with the surgical instrument, wherein the generator is operableto generate a combined drive signal having an ultrasonic energycomponent and an RF energy component; and (c) an accessory deviceconfigured to operatively couple the generator with the surgicalinstrument, wherein the accessory device includes filter circuitryoperable to convert the combined drive signal to: (i) an ultrasonicdrive signal configured to energize the ultrasonic transducer to drivethe ultrasonic blade with ultrasonic energy, and (ii) an RF drive signalconfigured to energize the RF electrode with RF energy sufficient toseal tissue.

Example 17

The surgical system of Example 16, wherein the accessory device isarranged externally of the surgical instrument and the generator.

Example 18

The surgical system of any of Examples 16 through 17, wherein theaccessory device comprises one of a power cable configured to couple tothe surgical instrument or a cable adapter configured to couple thepower cable to the generator.

Example 19

A method of delivering energy to a surgical instrument having anultrasonic blade and an RF electrode: (a) generating a combined drivesignal with a generator, wherein the combined drive signal includes anultrasonic energy component and an RF energy component; (b) receivingthe combined drive signal with an accessory device that communicateswith the generator and with the surgical instrument, wherein theaccessory device includes filter circuitry; (c) filtering the combineddrive signal with the filter circuitry to produce an ultrasonic drivesignal and a separate RF drive signal; (d) transmitting the ultrasonicdrive signal and the RF drive signal from the accessory device to thesurgical instrument so that: (i) the ultrasonic drive signal energizesan ultrasonic transducer to drive the ultrasonic blade with ultrasonicenergy, and (ii) the RF drive signal energizes the RF electrode with RFenergy sufficient to seal tissue.

Example 20

The method of Example 19, wherein the accessory device comprises atleast one of a power cable or a cable adapter.

IV. Miscellaneous

It should be understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Theabove-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims.

Further, any one or more of the teachings, expressions, embodiments,examples, etc. described herein may be combined with any one or more ofthe teachings, expressions, embodiments, examples, etc. described inU.S. Pat. App. No. [Atty. Ref. END8245USNP], entitled “CombinationUltrasonic and Electrosurgical Instrument Having Electrical CircuitsWith Shared Return Path,” filed on even date herewith; U.S. Pat. App.No. [Atty. Ref. END8245USNP1], entitled “Combination Ultrasonic andElectrosurgical Instrument Having Slip Ring Electrical ContactAssembly,” filed on even date herewith; U.S. Pat. App. No. [Atty. Ref.END8245USNP2], entitled “Combination Ultrasonic and ElectrosurgicalInstrument Having Electrically Insulating Features,” filed on even dateherewith; U.S. Pat. App. No. [Atty. Ref. END8245USNP3], entitled“Combination Ultrasonic and Electrosurgical Instrument Having CurvedUltrasonic Blade,” filed on even date herewith; U.S. Pat. App. No.[Atty. Ref. END8245USNP4], entitled “Combination Ultrasonic andElectrosurgical Instrument Having Clamp Arm Electrode,” filed on evendate herewith; U.S. Pat. App. No. [Atty. Ref. END8245USNP5], entitled“Combination Ultrasonic and Electrosurgical Instrument Having UltrasonicWaveguide With Distal Overmold Member,” filed on even date herewith;and/or U.S. Pat. App. No. [Atty. Ref. END8245USNP7], entitled“Combination Ultrasonic and Electrosurgical System Having EEPROM andASIC Components,” filed on even date herewith. The disclosure of each ofthese applications is incorporated by reference herein.

Further, any one or more of the teachings, expressions, embodiments,examples, etc. described herein may be combined with any one or more ofthe teachings, expressions, embodiments, examples, etc. described inU.S. Pat. App. No. [Atty. Ref. END8146USNP], entitled “CombinationUltrasonic and Electrosurgical Instrument with Clamp Arm Position Inputand Method for Identifying Tissue State,” filed on even date herewith;U.S. Pat. App. No. [Atty. Ref. END8146USNP1], entitled “CombinationUltrasonic and Electrosurgical Instrument with Adjustable EnergyModalities and Method for Sealing Tissue and Inhibiting TissueResection,” filed on even date herewith; U.S. Pat. App. No. [Atty. Ref.END8146USNP2], entitled “Combination Ultrasonic and ElectrosurgicalInstrument with Adjustable Clamp Force and Related Methods,” filed oneven date herewith; U.S. Pat. App. No. [Atty. Ref. END8146USNP3],entitled “Combination Ultrasonic and Electrosurgical Instrument withAdjustable Energy Modalities and Method for Limiting Blade Temperature,”filed on even date herewith; U.S. Pat. App. No. [Atty. Ref.END8146USNP4], entitled “Combination Ultrasonic and ElectrosurgicalInstrument and Method for Sealing Tissue with Various TerminationParameters,” filed on even date herewith; and/or U.S. Pat. App. No.[Atty. Ref. END8146USNP5], entitled “Combination Ultrasonic andElectrosurgical Instrument and Method for Sealing Tissue in SuccessivePhases,” filed on even date herewith. The disclosure of each of theseapplications is incorporated by reference herein.

It should be appreciated that any patent, publication, or otherdisclosure material, in whole or in part, that is said to beincorporated by reference herein is incorporated herein only to theextent that the incorporated material does not conflict with existingdefinitions, statements, or other disclosure material set forth in thisdisclosure. As such, and to the extent necessary, the disclosure asexplicitly set forth herein supersedes any conflicting materialincorporated herein by reference. Any material, or portion thereof, thatis said to be incorporated by reference herein, but which conflicts withexisting definitions, statements, or other disclosure material set forthherein will only be incorporated to the extent that no conflict arisesbetween that incorporated material and the existing disclosure material.

Versions of the devices described above may have application inconventional medical treatments and procedures conducted by a medicalprofessional, as well as application in robotic-assisted medicaltreatments and procedures. By way of example only, various teachingsherein may be readily incorporated into a robotic surgical system suchas the DAVINCI™ system by Intuitive Surgical, Inc., of Sunnyvale, Calif.Similarly, those of ordinary skill in the art will recognize thatvarious teachings herein may be readily combined with various teachingsof any of the following: U.S. Pat. No. 5,792,135, entitled “ArticulatedSurgical Instrument For Performing Minimally Invasive Surgery WithEnhanced Dexterity and Sensitivity,” issued Aug. 11, 1998, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.5,817,084, entitled “Remote Center Positioning Device with FlexibleDrive,” issued Oct. 6, 1998, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 5,878,193, entitled “Automated EndoscopeSystem for Optimal Positioning,” issued Mar. 2, 1999, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 6,231,565,entitled “Robotic Arm DLUS for Performing Surgical Tasks,” issued May15, 2001, the disclosure of which is incorporated by reference herein;U.S. Pat. No. 6,783,524, entitled “Robotic Surgical Tool with UltrasoundCauterizing and Cutting Instrument,” issued Aug. 31, 2004, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.6,364,888, entitled “Alignment of Master and Slave in a MinimallyInvasive Surgical Apparatus,” issued Apr. 2, 2002, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 7,524,320,entitled “Mechanical Actuator Interface System for Robotic SurgicalTools,” issued Apr. 28, 2009, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 7,691,098, entitled “Platform Link WristMechanism,” issued Apr. 6, 2010, the disclosure of which is incorporatedby reference herein; U.S. Pat. No. 7,806,891, entitled “Repositioningand Reorientation of Master/Slave Relationship in Minimally InvasiveTelesurgery,” issued Oct. 5, 2010, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 8,844,789, entitled“Automated End Effector Component Reloading System for Use with aRobotic System,” issued Sep. 30, 2014, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 8,820,605, entitled“Robotically-Controlled Surgical Instruments,” issued Sep. 2, 2014, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.8,616,431, entitled “Shiftable Drive Interface forRobotically-Controlled Surgical Tool,” issued Dec. 31, 2013, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.8,573,461, entitled “Surgical Stapling Instruments with Cam-DrivenStaple Deployment Arrangements,” issued Nov. 5, 2013, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 8,602,288,entitled “Robotically-Controlled Motorized Surgical End Effector Systemwith Rotary Actuated Closure Systems Having Variable Actuation Speeds,”issued Dec. 10, 2013, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 9,301,759, entitled“Robotically-Controlled Surgical Instrument with SelectivelyArticulatable End Effector,” issued Apr. 5, 2016, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 8,783,541,entitled “Robotically-Controlled Surgical End Effector System,” issuedJul. 22, 2014, the disclosure of which is incorporated by referenceherein; U.S. Pat. No. 8,479,969, entitled “Drive Interface for OperablyCoupling a Manipulatable Surgical Tool to a Robot,” issued Jul. 9, 2013;U.S. Pat. No. 8,800,838, entitled “Robotically-Controlled Cable-BasedSurgical End Effectors,” issued Aug. 12, 2014, the disclosure of whichis incorporated by reference herein; and/or U.S. Pat. No. 8,573,465,entitled “Robotically-Controlled Surgical End Effector System withRotary Actuated Closure Systems,” issued Nov. 5, 2013, the disclosure ofwhich is incorporated by reference herein.

Versions of the devices described above may be designed to be disposedof after a single use, or they can be designed to be used multipletimes. Versions may, in either or both cases, be reconditioned for reuseafter at least one use. Reconditioning may include any combination ofthe steps of disassembly of the device, followed by cleaning orreplacement of particular pieces, and subsequent reassembly. Inparticular, some versions of the device may be disassembled, and anynumber of the particular pieces or parts of the device may beselectively replaced or removed in any combination. Upon cleaning and/orreplacement of particular parts, some versions of the device may bereassembled for subsequent use either at a reconditioning facility, orby a user immediately prior to a procedure. Those skilled in the artwill appreciate that reconditioning of a device may utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

By way of example only, versions described herein may be sterilizedbefore and/or after a procedure. In one sterilization technique, thedevice is placed in a closed and sealed container, such as a plastic orTYVEK bag. The container and device may then be placed in a field ofradiation that can penetrate the container, such as gamma radiation,x-rays, or high-energy electrons. The radiation may kill bacteria on thedevice and in the container. The sterilized device may then be stored inthe sterile container for later use. A device may also be sterilizedusing any other technique known in the art, including but not limited tobeta or gamma radiation, ethylene oxide, or steam.

Having shown and described various embodiments of the present invention,further adaptations of the methods and systems described herein may beaccomplished by appropriate modifications by one of ordinary skill inthe art without departing from the scope of the present invention.Several of such potential modifications have been mentioned, and otherswill be apparent to those skilled in the art. For instance, theexamples, embodiments, geometrics, materials, dimensions, ratios, steps,and the like discussed above are illustrative and are not required.Accordingly, the scope of the present invention should be considered interms of the following claims and is understood not to be limited to thedetails of structure and operation shown and described in thespecification and drawings.

I/We claim:
 1. A surgical system comprising: (a) a surgical instrument,comprising: (i) a body, (ii) a shaft extending distally from the body,(iii) an ultrasonic transducer supported by the body, and (iv) an endeffector arranged at a distal end of the shaft, wherein the end effectorcomprises: (A) an ultrasonic blade, wherein the ultrasonic transducer isoperable to drive the ultrasonic blade with ultrasonic energy, and (B)an RF electrode operable to seal tissue with RF energy; (b) a generatoroperatively coupled with the surgical instrument, wherein the generatoris operable to generate a combined drive signal having an ultrasonicenergy component and an RF energy component; and (c) filter circuitryarranged externally of the body of the surgical instrument, wherein thefilter circuitry is operable to convert the combined drive signal to:(i) an ultrasonic drive signal configured to energize the ultrasonictransducer to drive the ultrasonic blade with ultrasonic energy, and(ii) an RF drive signal configured to energize the RF electrode with RFenergy sufficient to seal tissue.
 2. The surgical system of claim 1,further comprising: (a) a power cable configured to couple to thesurgical instrument; and (b) a cable adapter configured to couple thepower cable with the generator, wherein the filter circuitry is arrangedwithin one of the power cable or the cable adapter.
 3. The surgicalsystem of claim 2, wherein the power cable is configured to releasablycouple to the cable adapter.
 4. The surgical system of claim 2, whereinthe filter circuitry is arranged within the cable adapter.
 5. Thesurgical system of claim 2, wherein the filter circuitry is arrangedwithin the power cable.
 6. The surgical system of claim 1, wherein thefilter circuitry is integrated with the generator.
 7. The surgicalsystem of claim 1, wherein a distal end of the power cable is configuredto releasably couple with the body.
 8. The surgical system of claim 1,wherein a distal end of the power cable is configured to couple with aproximal end of the body.
 9. The surgical system of claim 8, wherein thedistal end of the cable is configured to align coaxially with theultrasonic transducer when the power cable is coupled with the body. 10.The surgical system of claim 1, wherein the ultrasonic transducer ishoused within an interior of the body.
 11. The surgical system of claim1, wherein the ultrasonic transducer is supported externally of thebody.
 12. The surgical system of claim 11, wherein the filter circuitryis integrated with the ultrasonic transducer.
 13. The surgical system ofclaim 1, wherein the RF electrode is provided by the ultrasonic blade.14. The surgical system of claim 1, wherein the RF electrode comprises afirst RF electrode, wherein the RF drive signal is configured toenergize the first and second RF electrodes with bipolar RF energysufficient to seal tissue.
 15. The surgical system of claim 14, whereinthe end effector further comprises a clamp arm, wherein the clamp armprovides the first RF electrode and the ultrasonic blade provides thesecond RF electrode.
 16. A surgical system comprising: (a) a surgicalinstrument, comprising: (i) an ultrasonic transducer, (ii) a shaftextending distally relative to the ultrasonic transducer, and (iii) anend effector arranged at a distal end of the shaft, wherein the endeffector comprises: (A) an ultrasonic blade, wherein the ultrasonictransducer is operable to drive the ultrasonic blade with ultrasonicenergy, and (B) an RF electrode operable to seal tissue with RF energy;(b) a generator operatively coupled with the surgical instrument,wherein the generator is operable to generate a combined drive signalhaving an ultrasonic energy component and an RF energy component; and(c) an accessory device configured to operatively couple the generatorwith the surgical instrument, wherein the accessory device includesfilter circuitry operable to convert the combined drive signal to: (i)an ultrasonic drive signal configured to energize the ultrasonictransducer to drive the ultrasonic blade with ultrasonic energy, and(ii) an RF drive signal configured to energize the RF electrode with RFenergy sufficient to seal tissue.
 17. The surgical system of claim 16,wherein the accessory device is arranged externally of the surgicalinstrument and the generator.
 18. The surgical system of claim 16,wherein the accessory device comprises one of a power cable configuredto couple to the surgical instrument or a cable adapter configured tocouple the power cable to the generator.
 19. A method of deliveringenergy to a surgical instrument having an ultrasonic blade and an RFelectrode, the method comprising: (a) generating a combined drive signalwith a generator, wherein the combined drive signal includes anultrasonic energy component and an RF energy component; (b) receivingthe combined drive signal with an accessory device that communicateswith the generator and with the surgical instrument, wherein theaccessory device includes filter circuitry; (c) filtering the combineddrive signal with the filter circuitry to produce an ultrasonic drivesignal and a separate RF drive signal; (d) transmitting the ultrasonicdrive signal and the RF drive signal from the accessory device to thesurgical instrument so that: (i) the ultrasonic drive signal energizesan ultrasonic transducer to drive the ultrasonic blade with ultrasonicenergy, and (ii) the RF drive signal energizes the RF electrode with RFenergy sufficient to seal tissue.
 20. The method of claim 19, whereinthe accessory device comprises at least one of a power cable or a cableadapter.